DELAYING PHYSICAL THERAPY CAN BE COSTLY

Up to 80 percent of people will at some point experience acute low back pain, and in most cases it will resolve on its own within four to six weeks, but with a high recurrence rate. However, recent large studies have shown that early start of physical therapy treatment may lead to less need for additional health-care treatment down the road.

A new study led by physical therapist Julie M. Fritz, published in the medical journal Spine, used a national database of employer-sponsored health plans, where 32,070 patients had newly consulted a primary care physician for low back pain. Those who were referred to a physical therapist within 14 days of consultation were compared to patients who had their physical therapy referral delayed until 15 to 90 days after initial consultation with a physician.

During an 18-month follow-up, the researchers found that early physical therapy treatment was associated with reduced likelihood of subsequent surgery, injections, physician visits, opioid use, advanced imaging, along with a corresponding reduction in related medical costs relative to delayed treatment by a physical therapist. The total health-care cost was $2,736 lower in the early treatment group.

Another recently published study, taken from data from the Centers for Medicare and Medicaid Services, looked at 439,195 patients who received treatment for acute low back pain, and who received physical therapy in the acute phase (less than 4 weeks) versus in the chronic phase (more than 3 months). This study also showed less subsequent medical services among patients who received physical therapy early after an episode of acute low back pain, versus later on. Fritz suggested that early physical therapy may promote a greater sense of self-reliance in managing low back pain and confidence in a positive outcome. It may also prevent patients’ dependency on additional health care services and medications.

Although the literature has shown evidence of moderate benefit of exercise therapy for chronic and sub acute low back pain, a systematic review has shown strong evidence that exercise can reduce the future occurrence of back problems in adults.